Congratulations to Dr. Vwaire Orhurhu and Dr. Lindsay Sween who received the Outstanding Resident Teaching Award earlier this month. This award is given to the residents who worked with the 2nd and 3rd year HMS students during clinical rotations as part of their Principal Clinical Experience at BIDMC.

JUST BREATHEA n E S T H E S I A , C R I T I C A L C A R E A n D PA I n M A n A g E M E n T

D E PA RTM E n TA L T I M E O U T

Hello All

As the new academic year begins, I’d like to welcome our new faculty, staff, and

trainees to our Anesthesia family. I would also like to introduce our inaugural

Anesthesia Monthly Departmental newsletter. This is just one component of a larger commitment

to foster open communication within our growing Department. We hope to use this channel to

share both serious and light-hearted content with you. We’ll keep you informed—so you can stay

connected. And we hope that you’ll contribute, too. Just submit your news above. I look forward to

hearing your thoughts.

Danny

WELCOME

Thanks to our tireless recruit-ment and on-boarding team, we’ve added 17 new staff across the department since January. Ten more attendings, and 4 CRnAs will be joining us by September 1. We appreciate your ongoing help to integrate and orient new staff to our practice.

Did you know? To cover 44 operating rooms, we need 89 FTEs of staff, 80 residents and fellows, 25 Boston CRnAs, and 12 Milton CRnAs. Stay tuned for updates...

HMFP LEAVE POLICY

WHAT’S nEW In OUR...

COMMUNITY!

MILTON NEEDHAM PLYMOUTH

• The Milton Spring gala, Shining a Light on Outstanding Care on May 6th presented by the Marr Family raised funds to support the patient experience. The Charles C. Winchester Distin-guished Community Service Award was presented to Edward ned Corcoran II for his leader-ship in the Milton Community and support of BID-Milton.

• Also in May, a Spring Dinner Meeting was held for the Women Physicians group.

• The kickoff for our First Case On Time Start project is July 1 with a goal of 95%.

• A new Joint Replacement Surgeon has joined the staff and will be starting this summer. Please welcome Dr. Jake Drew.

• Plans are proceeding for a new clinical building to be built adjacent to the hospital, which will house—among other—clinics a new endoscopy suite.

• Plymouth welcomes Kevin Coughlin newly appointed President and CEO of BID-Plymouth.

• BID-Plymouth has been named a Leapfrog Top Hospital for enhancing patient safety and quality—One of 115 hospitals in the United states, and one of just two in Massachusetts.

WORK TO BE PROUD OF

HAVE A HAPPY AnD SAFE 4TH OF JULY!

V O LU M E 1 I S S U E 1

J U LY 2 0 1 7

STAFF CELEBRATIng 10-40 YEARS attended an evening of friends, fun and

fabulous food at Alden Castle in Brookline. Alan Lisbon accepts his award for 40

years of service from President and CEO of BIDMC, Peter Healy.

gOT SOMETHIng TO SAY? WAnT TO COnTRIBUTE? SPOT An ERROR? E-mail Heather Derocher at hderoche@bidmc.harvard.edu

Congrats to our staff listed here for celebrating a

service milestone this year! We recognize your

accomplishments, and appreciate your dedication,

and hard work over the years. Thank you!

nEW ATTEnDIngSJoshua Mollov, MD Coming from BID-Plymouth

Hyun Kee Chung, MD Coming from UMass Memorial Medical

Cyrus Yazdi, MD Coming from UMass Memorial Medical

Andrew Koropey, MD Coming from Morton Hospital, Taunton

Syed H. Mahmood, MD PM&R Physician, Pain Clinic

Cristin McMurray, MD Rejoining Dept. In OR/PAIn

nEW ADMInISTRATIVE STAFFRobert Carlin Senior Project Manager

Heather Derocher Director of Communications and Special Projects

gidget Hunter Admin on East

Ann Plasso Admin on West

Elizabeth Slowinski Project Coordinator

Kassandra Primatello Summer Intern

Our revenue is directly related to the generation of the

Anesthesia Record—which documents the clinicians’

entire work cycle from start to finish. It

is important to know when to start and

stop documenting a case. Start time

(A Time) and finish time (D Time) ARE

nOT in-room and out-of-room times,

nor is it surgery start and stop times.

We must roll back our A time, and ad-

vance our D time, to account for time

spent with a patient in the HOLDIng

AREA and PACU.

BE THOROUgH, EDIT SWIFTLY

Each day Coders send out e-mails with

incomplete records, times overlapping

(concurrency), and times missing.

Most of us respond in a timely manner.

However, Coders also send out a list

each month of those who have not re-

sponded for 1,2, or 3 months. This can

no longer happen. If a Coder reaches

out to you, you must respond—if

not that day, that same week. At this

time Coders are still reconciling some

March cases. Part of our clinical re-

sponsibility is to complete documenta-

tion on time. This ensures the Coders

will get the bills to the billing company on time so we can

collect payment on time. There is a direct relationship

between incomplete records and loss of revenue. There is

a finite timeline for billing and collecting money. Please

fill out your Anesthesia Records accurately and respond to

the Coders requests swiftly.

YOU HAVE SUPPORT: Admin staff in place to assist

Molly and gidget are on each campus, and serve as the

front line with the ability to go in and change the Record

(they cannot do attestations). This allows Trinia to be

able to focus on getting bills out the door with less inter-

ruptions for requests to change records. Continue to use

Trinia as needed until gidget and Molly are up to speed.

A-TIME WORKFLOW: Currently, when you bring a patient

back to an OR room and click “Case start,” this logs the

patient in the room, and also logs the A time (as well as B

time): “Start of anesthesia care.” The reason it starts at

this point is because it is a hard start that you can control.

But really, the care starts in the holding area when you

begin to take care of the patient.

HOLDING AREA CARE: (Consents, IV an-

swering questions, IDing, transporting)

is billable time and should be included

in your A time. Pre-op evaluation is not

included, because it is bundled in to the

anesthetic. Also time doing procedures

that are billed separately (A-lines,

blocks, epidural) are not to be included

in your A time. If you leave the patient

prior to the start of the case you cannot

include this time. Essentially you are

cutting and pasting the time spent, for

time that is billable prior to the B time.

This is an accepted practice. The most

AIMS allows you to roll back the A time

is 30 minutes.

We don’t want anyone to be untruthful

in their documentation. The documenta-

tion should reflect the care provided.

These minutes may seem trivial but they

do add up. In fact, improper documenta-

tion of A and D times cost the depart-

ment nearly 25% of our entire bonus

pool. Documentation will now be presented in annual

reviews. It is part of our professionalism to ensure proper

documentation, and support the department. Thank you

for your attention to this matter.

D-TIME WORKFLOW: When you click “out of room,” that

accounts for the C time. When you close the record in

the PACU or ICU, that accounts for the D time. given the

workflow of signout, you are often still providing several

minutes of care after you print the record. The only way

to account for this in the D time is by advancing it (after

closing, prior to printing) to represent the continued time

caring for the patient prior to transitioning them to the

nurses.

Everyone can do a little better. Please educate new staff,

residents, and CRnAs of the proper routine. Education

materials listing the basic rules and understanding of

what you can and cannot do, and expected practice, are

being generated and will be available very soon.

nEW HIRES

Documentation of Start and Finish Times

SEASONED EMPLOYEES

JOHn MITCHELL, MD, received the inaugural Philip Liu Award for Innovation in Anesthesia Education—Education Research at the Society for Education in Anesthesia (SEA) 2017 Spring Meeting in Jacksonville, FL, on April 29.

The project – “Improving Resident Com-munication Skills with a Customizable Curriculum” –was presented at the meeting, and his co-investigators include: Cindy Ku, MD; Brendan Lutz, BS (Edward Via College of Osteopathic Medicine); Sajid Shahul, MD, MPH (University of Chicago Medicine); Van-essa Wong, BS; and Stephanie Jones, MD.

The Philip Liu Award for Innovation in Anes-thesia Education was established through the Dr. Philip Liu Fund for Medical Education of the Hawaii Community Foundation, and consists of two categories: Education Research, to recognize “outstanding anes-thesia education research”; and Innovation in Curriculum, to recognize “innovations in curriculum that will improve education in anesthesia.” The award includes a plaque and $1000 cash award.

CInDY KU, MD, received the second annual SEAd grant, a $10,000 education research grant given by the Society for Education in Anesthesia (SEA) 2017 Spring Meeting in Jacksonville, FL, on April 29. The purpose of the SEAd grant is to “inspire and assist” faculty in starting an educational research project.

The research study – “Project Pandemic: Efficient and Effective Teamwork and Com-munication Skills Training Using a Tabletop game” – will investigate if essential non-technical skills, such as communication and teamwork, can be efficiently and effectively developed in anesthesia trainees using a game-based education intervention in a non-clinical, classroom setting. The project team includes: Cullen Jackson, PhD (Co-PI); John Mitchell, MD (Co-I); Vanessa Wong, BS; and Stephanie Jones, MD (Mentor).

AnnA BUDDE, MD, received a SEA-HVO Traveling Fellowship at the Society for Education in Anes-thesia (SEA) 2017 Spring Meeting in Jacksonville, FL, on April 29.

From the SEA Website: “The SEA-HVO Fellowship allows senior anesthesia residents the opportunity to improve anesthesia care in resource-scarce countries by teaching and mentoring their counter-parts. The SEA-HVO Fellows witness a wide range of surgical pathologies and anesthetic techniques not commonly seen in the United States. They learn to communicate more effectively with people from different cultures and observe the realities and constraints of delivering health care in a resource-scarce environment. Most importantly, SEA-HVO Fellows serve as teachers of anesthesia and role models for anesthesia students at HVO project sites and contribute to the safety of future patients receiving anesthesia.”

Anna will serve a one month assignment at a Health Volunteers Overseas (HVO) anesthesia site.

Resources for you...LEAVE OF ABSEnCE: Whether you are HMFP staff, a trainee, or BIDMC, please familiarize yourself with the Leave of Absence Policy at the links below to understand: How to request a leave of absence; What paper-work you will need; What happens to your pay and benefits; What to do when you are ready to return.

BIDMC LEAVE POLICY

At this year’s Silverman Symposium 3 posters were presented by our residents, two of which came from the inaugural resident RCA program and had been previously presented at the department clinical conference.

Improving Patient-Centered Care Delivery in 2017: Introducing Pre-Anesthesia Decision Aids (Drs. Sween, Dr. Shapiro)

Medication Error: A Case Review and a Root Cause Analysis (Drs. gilleland, narvaez, Min, neves, Rana)

Where is the blood? A Quality Improvement Project in Periopera-tive Blood Bank Ordering (Drs. Parzych, Keverian, Zhang, and Kunze)

ISABELLA RHAE ARAM JASPER

Congrats to Dr. Qi Ott and proud Dad Harald, whose daughter Isabella Rhae was born May 17! Delighted siblings, Sophia and Alexander are vying for cuddle time. And thanks to Jeff Martel for another perfect epidural.

Congrats to Dr. Shaz Shaefi and wife Adrina, whose son Aram Jasper was born June 22! Sister Sabine—mommy’s little helper, has it under control. Thank you to all involved in their care, particularly Dr. Stiles.

FUTURE COLLEAGUES?

Wednesday Morning Meditation

MILTOn nEEDHAM PLYMOUTH

Another Massachusetts born baby— one of our very own Anesthesiologists— who’s still working here today. Can you recognize this smile?

GUESS WHO?

with Dr. Bala Subramaniam 6:30am • Wednesday mornings

Trustman Boardroom, East Campus, near Caf. Please join us.

J U LY 19

State of the Department

Sherman Auditorium 7 – 8 am

Presenter: Dr. Daniel Talmor

J U LY 12

Resident Welcome & Service Awards Breakfast

Rabkin Board Room 7 – 9 am Shapiro Clinical Ctr, 10th Floor

J U LY 19

Anesthesia Research Rounds West/RB-439 Anesthesia Library

4:30 – 5:30 pm

Presenter: Dr. Brian O’gara

40 YEARS In SERVICE

Alan Lisbon, MDExecutive Vice Chair, AnesthesiaAssociate Professor of Anaesthesia

30 YEARS In SERVICE

Ana Cabrera-Delgado Medical Assistant Lead, Pain Clinic

30 YEARS In SERVICE

Joanne T. Cullen, RnClinical nurse III, Pain Clinic

15 YEARS In SERVICE

Ron WilburnAnesthesia Lead Technician

10 YEARS In SERVICE

Valerie M. Banner-goodspeed, MPH Clinical Research Administrator, CARE

10 YEARS In SERVICE

Ashley A. Lowery, nP nurse Practitioner, Anesthesia

Rajiv R. Doshi, MDInstructor in Anaesthesia

Jatinder S. gill, MD MB MSAssistant Professor of Anaesthesia

Eileen Lyons, CRnA

Caitlin J. Mcginty-Froncek, MDInstructor in Anaesthesia

Paragi H. Rana, MDInstructor in Anaesthesia

William Rice, CRnA, nP

Laura L. Sorabella, MDInstructor in Anesthesia

Justin K. Stiles, MDInstructor in Anesthesia

Minghan Leo Tsay, MDInstructor in Anaesthesia

norma Osborn, nP

nick I. RamiAnesthesia Technician

Priyam Mathur, MSData Analyst

DATES TO REMEMBER

BEST PRACTICE

Resident & Fellows Graduation Awards

Third Annual Anesthesia Resident Professionalism Award 2016-2017CA-1: Sam Kurtis, MDCA-2: Kiran Belani, MDCA-3: Beth VanderWielen, MD

John Hedley-Whyte Prize in Critical Care Medicine 2017 Elise Sullivan, MD

Nancy E. Oriol Award in Obstetric Anesthesia 2017 Maggie O’Donoghue, MD

Edward Lowenstein Award in Cardiac Anesthesia 2017 Kim Hollander, MD

Thoracic Anesthesia Award 2017 Scott gilleland, MD

Vascular Anesthesia Award 2017 Obaid Malik, MD

Neuro Anesthesia Award 2017 Lauren Buhl, MD, PhD

Carol A. Warfield Award in Pain Management 2017 Kim Hoang, MD

Chief Residents Award 2016-2017Stanley Eosakul, MDMargaret O’Donoghue, MDBeth VanderWielen, MD

Stephen Loring Research Award 2017 Beth VanderWielen, MD

Laasberg /Johnson Research Award 2017 Phil Hess, MD

Excellence in Education Award 2017Margaret O’Donoghue, MDStanley Eoasakul, MDBeth VanderWielen, MD Alexander Shapeton, MD

Teacher of the Year Award 2017 Robert Leckie, MD

2016-2017 Graduation

Families and friends of the class of 2017 were beaming with pride as they watched our Anesthesia Residents and Fellows receive certificates of completion and awards at the new England Aquarium two weeks ago on a rainy Friday evening, June 16th.

Due to the torrential conditions, the celebration was moved inside, where our youngest guests remained entertained, and the penguins proved to be quite a captive audience—squawking to celebrate the graduates during the presentation. However, once their bedtime rolled around, even Dr. Panzica’s (emcee) voice couldn’t keep our flightless, feathered friends engaged any longer! Snapshots from the evening can be viewed here:

GRADUATESRESIDENTS

Lauren Buhl, MD, PhDSarah Burnett, MDErin Ciampa, MD

Susan Eklund, MDStanley Eosakul, MD

Kimberly (naden) Hollander, MDnayema Khan, MD

Diana Liu, MDObaid Malik, MD

Margaret O’Donoghue, MDJulia Parzych, MDAlyce Richard, MD

Lindsay Rubenstein, MDAlexander Shapeton, MDAlan Sheydwasser, MD

Tori Sutherland, MDBeth VanderWielen, MD

INTERNSTahir Ahmed, MDHebah Ismail, MD

Daniel Mcgrail, MDMario Montealegre, MDPriya Ramaswamy, MD

Janna Taylor, MD

FELLOWSHIPSREGIONAL ANESTHESIA

Irina Fishman, MD

CRITICAL CAREBarry Kelly, MD

Ilan Mizrahi, MDAmeeka Pannu, MDJohann Patlak, MD

ADULT CARDIOTHORACIC ANESTHESIA

Patrick Kinnaird, MDAbirami Kumaresan, MD

PAIN MEDICINERoss Barker, MD

Viet Cai, MDSherry Chang Kinnaird, MD

Mohamed Bilal Chaudary, MDKim Hoang, MD

Andrew Rubens, MDOmar Syed, MD

OB ANESTHESIAnathan Liu, MD

SEA

YEARS IN SERVICE AWARDS

nEW FELLOWSHIPSWe have just received accreditation from the United Council for neurologic Subspecialties for our neurocritical Care Program. The neuroanesthesia Fellowship and neurocritical Care Fellowship are both kicking off July 1st, and we are pleased to announce our first fellows:

nEUROCRITICAL CARE FELLOWSHIP Johann Patlak, MD

University of Vermont, College of MedicineBIDMC

nEUROAnESTHESIA FELLOWSHIP Lauren Buhl, MD, PhDHarvard Medical SchoolBIDMC

Fixing our workflow internally will help improve our revenue cycle.

LIFE OF An AnESTHESIA RECORD

When you generate an Anesthesia

Record, it is sent to the Coders

in our Department (Robin and

Susan on Yamins 2, and Trinia and

Chloe on Feldberg 4). The Coders

take your Anesthesia Record and

produce a billing code for each

step in your process. That billing

code then goes to our wholly

owned billing company, Anesthe-

sia Financial Services (AFS), in

needham. next, AFS sends that

bill to insurance companies, and

follows up to make sure we’re paid

for that bill. Money comes in to

AFS, money is sent back to HMFP,

our billing company makes a small

profit (which then goes to the

Anesthesia Foundation where it’s

kept for supports and research for

our Department).

TRAInEE LEAVE POLICY

5 YEARS In SERVICE

STARTIng In JULY

Johann Patlak, MD

graduating fellow, starting

neurocritical Care Fellowship/OR

Barry Kelley, MD

graduating fellow,

starting Critical Care/OR

Ameeka Pannu, MD

graduating fellow,

starting Critical Care/OR

Patrick Kinnaird, MD

graduating fellow,

starting OR

The Anesthesia Patient Safety Program was developed by CRICO in 2000 to improve the safety of patients, and decrease complications—by enhancing communication and teamwork, to improve response to low frequency, high-risk patient events.

The program is based on a repeating three-year training cycle of approved course content for all CRICO-insured Anesthesiologists (Attendings, Fellows and Residents). By tracking and reporting training, BIDMC can achieve a pre-mium reduction (up to 45%) from the annual premiums paid for participating members.

Our department has been participating in this Program, and will continue to review/expand courses (existing and/or new ) that meet guidelines to achieve a reduction of cost to our department and the Hospital. The departmental pen-alty (added cost) for not completing the requisite training is more than $5000 per year, per faculty member. All our department staff are compliant with the year 1 activity, but we are significantly behind schedule for compliance with year 2 activities. Our project team is currently working with CRICO to implement additional training courses to satisfy the Program requirements. Clinicians will hear more soon about fulfilling the year two obligation. Please reach out to Dr. Krish Ramachandran, Dr. Cullen Jackson, or Bob Carlin with any questions.

CRICO’s Anesthesiology Patient Safety Program [CRICO is our provider of malpractice insurance.]

VIEW PHOTOS

Education HighlightsVIEW POSTERS

(Pardon any missing team members, only submitting authors listed.)

OUTSTAnDIng RESIDEnT-FELLOW-nURSIng TEACHIng AWARD

SILVERMAn SYMPOSIUM

not pictured: Susan M. giordano Senior Coder

not pictured:

nEW RESEARCH STAFF Melissa Patxot CARE

not pictured:

Kiera Anderson Interim Coding Manager

Chloe Setayesh Coder

UPCOMIng EVEnTS(See below)

SUBMIT nEWS Hderoche@BIDMC.Harvard.edu

A R C H I V E D n E W S L E T T E R S C A n B E F O U n D O n T H E A n E S T H E S I A I n T R A n E T